European Journal of Pediatrics最新文献

{"title":"Evaluation of testicular function in 1-2-year-old cryptorchid children with alterations of anti-mullerian hormone after various orchidopexy.","authors":"Chenjie Zhang, Chunsheng Hao, Zhishang Niu, Jinqiu Song, Ying Qiu, Yalin Wang, Dongsheng Bai","doi":"10.1007/s00431-025-06190-w","DOIUrl":"https://doi.org/10.1007/s00431-025-06190-w","url":null,"abstract":"<p><p>This study assessed testicular function in children with cryptorchidism following different orchidopexy procedures by measuring serum anti-Müllerian hormone (AMH). The aim was to identify clinical factors associated with testicular function recovery by comparing pre- and post-operative levels of AMH, luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and testicular volume at various time points. This prospective observational cohort study included children aged 1 to 1.5 years diagnosed with cryptorchidism via physical examination and ultrasound. The study evaluated testicular function parameters before and after two different orchidopexy techniques, measured at five intervals. Serum AMH was the primary outcome, with FSH, LH, testosterone, and testicular volume as secondary measures. A control group of 57 healthy male infants aged 1 to 2 years was included for comparative analysis. A total of 138 patients were enrolled, with testicular function evaluated preoperatively and at 10 days, 1 month, 3 months, and 6 months post-surgery. Preoperative AMH levels were significantly higher in unilateral compared to bilateral cryptorchidism (P < 0.05). Postoperatively, AMH levels increased by 3 months in children with palpable testicles and by 6 months in those with non-palpable testicles (P < 0.05), with no significant difference between groups at 6 months. Cases with intraperitoneal release procedures also showed significant AMH increases at 3 and 6 months (P < 0.05), and testicular function improved similarly across surgical techniques.</p><p><strong>Conclusion: </strong>Orchidopexy can pose a risk of injury, emphasizing the need for careful treatment planning. While surgical technique did not significantly affect outcomes in children aged 1 to 1.5 years, serum AMH is a valuable tool for preoperative evaluation and prognosis in cryptorchidism.</p><p><strong>What is known: </strong>•Cryptorchidism impairs testicular function.•Orchidopexy improves function but varies by technique and testicular position.</p><p><strong>What is new: </strong>•AMH is a sensitive postoperative marker for testicular recovery.•Function improvement is consistent across surgical techniques, with intraperitoneal release showing significant AMH gains by 3-6 months.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"361"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salbutamol in 5q spinal muscular atrophy: a systematic review and meta-analysis of efficacy and safety.","authors":"Xiaodong Xing, Shuyan Zhao, Ruoyu Jiang, Wengao Jiang","doi":"10.1007/s00431-025-06184-8","DOIUrl":"https://doi.org/10.1007/s00431-025-06184-8","url":null,"abstract":"<p><p>Salbutamol, an agonist of the β2-adrenergic receptor, has demonstrated positive outcomes in spinal muscular atrophy (SMA). This systematic review and meta-analysis aimed to investigate its efficacy and safety in patients with SMA. Four biomedical databases (PubMed, Embase, Web of Science, Cochrane Library) and three conference abstract repositories were systematically searched on 1 February 2025 for related clinical studies. Primary outcomes were the motor function, respiratory function, and the peripheral survival motor neuron (SMN) transcript levels of SMA patients pre- and post-salbutamol. Secondary outcomes included musculoskeletal function metrics, patient-reported symptoms, and adverse events. A total of eight studies involving 154 subjects were included in the final analysis. Qualitative analysis revealed that a significant number of patients reported subjective improvements. Additionally, salbutamol has been shown to improve respiratory function and contribute to weight gain in certain younger individuals. Meta-analysis demonstrated that, in two selected studies, patients under 6 years old showed a substantial improvement in the Revised Upper Limb Module (RULM) scores (mean difference (MD) = 3.89, 95% confidence interval (CI) 0.35-7.43, P = 0.03) with no significant heterogeneity. Salbutamol also elevated the levels of peripheral SMN2 full-length transcripts, with statistical significance observed at 6 months (MD = 25.13, 95% CI 16.12-34.13, P < 0.00001) and sustained through to 12 months.</p><p><strong>Conclusion: </strong> Salbutamol represents a safe therapeutic option that holds considerable promise in the management of SMA, particularly among clinical responders and younger subgroups. Double-blind, randomized, controlled trials are required to confirm these findings.</p><p><strong>What is known: </strong>• Clinical trials in neuromuscular junction disorders report motor function gains associated with β2-agonists therapy, attributed to both muscle trophic effects and NMJ synaptic modulation. • Salbutamol, a β2-adrenergic receptor agonist, has been shown to increase full-length SMN2 mRNA and functional SMN protein levels in SMA patient-derived fibroblasts.</p><p><strong>What is new: </strong>• Salbutamol possesses the potential to improve motor function in patients with SMA and represents a safe therapeutic option that holds considerable promise in the management of SMA. • The potential mechanism of salbutamol in treating SMA patients may involve enhancing SMN2 transcript expression via cAMP regulation and increasing SMN protein levels by inhibiting ubiquitin-mediated SMN degradation through the β2 adrenergic receptor-PKA pathway. • Salbutamol emerges as a cost-effective and viable option for SMA patients in underdeveloped regions who lack access to or cannot afford disease-modifying treatments.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"358"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on the epidemiology of severe sinogenic and otogenic infections and their intracranial complications.","authors":"Dimitra Dimopoulou, Maria M Berikopoulou, Ioannis Tsoliakos, Athanasios Michos","doi":"10.1007/s00431-025-06188-4","DOIUrl":"10.1007/s00431-025-06188-4","url":null,"abstract":"<p><p>This study aims to evaluate the impact of COVID-19 pandemic on the incidence, microbiological characteristics, management, and outcomes of mastoiditis and orbital cellulitis and their intracranial complications in pediatric patients. A retrospective observational study was conducted at the major pediatric hospital of Athens from 1/2018 to 12/2023. Pediatric patients (0-16 years) diagnosed with mastoiditis, orbital cellulitis, and related complications were included. Data were collected across three periods: pre-pandemic (1/2018-3/2020), during the pandemic (4/2020-6/2021), and post-pandemic (7/2021-12/2023). Statistical analyses compared demographic, clinical, and microbiological characteristics between the periods. A total of 176 cases were included (76 mastoiditis and 100 orbital cellulitis cases). The in-hospital incidence of both infections increased significantly post-pandemic compared to the period before the pandemic (mastoiditis: 5.5 vs.13.6 per 1000 admissions; orbital cellulitis: 4.8 vs. 21.8 per 1000 admissions, P < 0.001). Streptococcus and Staphylococcus species predominated across the three periods. Median (IQR) age was not significantly different between the two periods among patients with mastoiditis (pre-pandemic: 5.6 (3.5) years vs. post-pandemic: 3.3 (3.4) years, P = 0.12) and among patients with orbital cellulitis (pre-pandemic: 9.2 (6.6) years vs. post-pandemic: 8 (9.2) years, P = 0.50). Regarding the complications, the rate of intracranial empyema/abscess development among patients with orbital cellulitis, but not mastoiditis, was lower post-pandemic compared to pre-pandemic (30% vs. 10.1%, P = 0.03).</p><p><strong>Conclusion: </strong>The study findings demonstrate a significant rise in the post-COVID-19 in-hospital incidence of mastoiditis and orbital cellulitis in children. Future epidemiological surveillance of these complications and pathogen-specific dynamics, are important to develop prevention strategies for these severe pediatric infections.</p><p><strong>What is known: </strong>• The COVID-19 pandemic shifted the epidemiology of severe upper respiratory tract infections. • Data on the epidemiology of severe sinogenic and otogenic infections and their intracranial complications during and after the acute phase of the COVID-19 pandemic are limited in Europe.</p><p><strong>What is new: </strong>• This study highlights a notable increase in the in-hospital incidence of mastoiditis and orbital cellulitis during the post-COVID-19 pandemic era, likely associated with immunity debt and alterations in respiratory microbiota. • Despite the increase in pediatric mastoiditis and orbital cellulitis cases, the rates of complications and surgical management remained stable throughout the study period.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"359"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and weight status of children in Germany: cross-sectional results from the MoMo Wave 3 (2018-2020).","authors":"Elena Brehm, Lara Tschuschke, Leon Klos, Alexander Burchartz, Carmen Volk, Anke Hanssen-Doose, Darko Jekauc, Claudia Niessner, Alexander Woll","doi":"10.1007/s00431-025-06183-9","DOIUrl":"10.1007/s00431-025-06183-9","url":null,"abstract":"<p><p>Childhood physical activity (PA) plays a critical role in preventing obesity and supporting overall health. This study investigates the prevalence of weight status categories and their association with organized and unorganized PA among 6- to 17-year-old children in Germany using MoMo Wave 3 (2018-2020). Cross-sectional data from MoMo Wave 3 (2018-2020) were analyzed to examine associations between weight status and PA. A total of 1983 participants (age: 11.6 ± 3.4 years, 52.3% male) completed a questionnaire and had anthropometric measurements taken, including height and weight. Statistical comparisons between normal-weight children and those classified as underweight or overweight based on their body mass index focused on their participation in organized and unorganized PA. Linear and logistic regressions were used for statistical analysis. Among the participants, 3.0% were severely underweight, 5.8% were underweight, 7.2% were overweight, and 4.6% were obese. Participants classified as underweight (ꞵ = - .084; p < .001) and overweight (ꞵ = - .045; p = .042) spent less time in organized PA compared to normal weights. Overweight participants were less likely to participate in unorganized PA (OR = .64, p = .003). No significant differences were observed in the duration of unorganized PA among those who participated, regardless of weight status.</p><p><strong>Conclusion: </strong>The prevalence of overweight and obesity has remained consistently high in recent years. Tailored interventions should address the specific barriers faced by both underweight and overweight children to enhance their participation in PA and improve health outcomes across diverse groups.</p><p><strong>What is known: </strong>• Children with overweight or obesity are less physically active than their normal-weight peers, underweight children are often as physically active as those with normal weight.</p><p><strong>What is new: </strong>• Children with overweight and underweight show less organized physical activities compared to their normal-weight peers. • Although overweight children engaged less frequently in unorganized physical activities, those who did participated for a similar duration as normal-weight children.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"360"},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial lung ultrasound in predicting the need for surfactant and respiratory course in preterm infants-multicentre observational study (SLURP).","authors":"P K Loganathan, V Meau-Petit, B Bhojnagarwala, V Nair, J Holmes, A Occhipinti, M Montasser","doi":"10.1007/s00431-025-06185-7","DOIUrl":"10.1007/s00431-025-06185-7","url":null,"abstract":"<p><p>Lung ultrasound (LUS) scores may predict surfactant need early and the progression of the respiratory course in preterm infants. The objective of this study is to report the diagnostic value of LUS scores performed by operators of varying levels of experience to predict the need for surfactant in preterm infants. A prospective observational study was conducted across 3 UK-based neonatal intensive care units. Preterm infants ≤ 34 weeks on non-invasive respiratory support within 3 h of birth were included. Ten lung zones were scored serially, first within the first 3 h of life, then at 12-24-h intervals (a total of four scans). All scans were performed by the local team members with formal training on LUS and varying levels of expertise. All the LUS videos were scored by an expert investigator who was blinded to clinical details. Written retrospective parental consents were obtained. We recruited 83 preterm infants ≤ 34 weeks (May 2023 to June 2024). A total of 325 LUS scans were performed by 27 clinical staff. The median birth gestational age and birth weight were 31 weeks and 1515 g, respectively. Twenty-eight (34%) babies received surfactants. The first LUS using a 6-zone method within 3 h of life predicted surfactant need and bronchopulmonary dysplasia with an AUC of 0.80 for both outcomes, offering sensitivity (79% and 73%) and specificity (75% and 76%), respectively.</p><p><strong>Conclusions: </strong> LUS performed by operators of varying levels of experience within the first 3 h of life is a reliable tool for predicting surfactant need in preterm infants ≤ 34 weeks.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ( https://clinicaltrials.gov/ ): NCT05782569.</p><p><strong>What is known: </strong>• There are considerable variations in the selection criteria of preterm infants for surfactant administration. • Lung ultrasound score has been shown to predict the need for surfactant early and the progression of respiratory course in preterm infants.</p><p><strong>What is new: </strong>• LUS performed within 3 h of life by operators of varying levels of experience and interpreted by expert predicted the need for surfactant deficiency in preterm infants. • Our research with a structured training programme enabled novice operators to perform LUS and achieve reasonable competency.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"356"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended vs. concise lung ultrasound scores to predict the need for respiratory support in bronchiolitis: a prospective observational study.","authors":"Seyfeddine Zayani, Farah Thabet, Abir Daya, Olfa Betbout, Bennasrallah Cyrine, Chokri Chouchane, Slaheddine Chouchane","doi":"10.1007/s00431-025-06189-3","DOIUrl":"10.1007/s00431-025-06189-3","url":null,"abstract":"<p><p>Lung ultrasound (LUS) has emerged as a valuable tool for assessing bronchiolitis severity, yet the optimal scoring system remains uncertain. This study aimed to compare the predictive performance of two LUS scoring methods-concise vs. extended-for determining the need for respiratory support in infants hospitalized with bronchiolitis. We conducted a prospective observational study including infants < 12 months hospitalized for bronchiolitis. All patients underwent LUS within 12 h of admission, performed by trained pediatricians blinded to clinical outcomes. The concise score assessed three lung regions per hemithorax, whereas the extended score included six regions per hemithorax. The primary outcome was the need for respiratory support (high-flow nasal cannula, noninvasive ventilation, or invasive mechanical ventilation). Interobserver agreement was assessed via the intraclass correlation coefficient (ICC). A total of 160 infants were included, with 87 (54.4%) requiring respiratory support. The extended LUS score demonstrated superior predictive performance (AUC = 0.879, 95% CI 0.824-0.934) compared to the concise score (AUC = 0.761, 95% CI 0.686-0.837, p < 0.001). The optimal cutoffs were 14 for the extended score (89.7% sensitivity, 78.1% specificity) and 7 for the concise score (79.3% sensitivity, 67.1% specificity). Interobserver reliability was good for both scores (ICC = 0.86 and 0.79).</p><p><strong>Conclusion: </strong>The extended LUS score exhibited higher predictive accuracy but at the expense of increased complexity. While both scores demonstrated clinical utility, further studies should explore the balance between feasibility and precision in bronchiolitis management.</p><p><strong>What is known: </strong>• Lung ultrasound (LUS) is increasingly used to assess the severity of bronchiolitis in infants. • Several LUS scoring systems exist, but there is no consensus on which score best predicts the need for respiratory support.</p><p><strong>What is new: </strong>• This study prospectively compares a concise and an extended LUS score to predict the need for advanced respiratory support in hospitalized infants. • The extended score had significantly higher diagnostic accuracy and clinically oriented cut-offs to guide triage decisions.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"357"},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased risk of admission to neonatal intensive care unit in neonates born to mothers with pregestational diabetes.","authors":"Dearbhla Hillick, Daniel O'Reilly, Lauren Murphy, Fionnuala Breathnach, Naomi McCallion","doi":"10.1007/s00431-025-06170-0","DOIUrl":"10.1007/s00431-025-06170-0","url":null,"abstract":"<p><p>The purpose of this study was to describe how maternal diabetes impacts admission to the neonatal intensive care unit to support healthcare professionals when counselling patients. The primary outcome was admission rates. A retrospective observational cohort study of 25,238 births was conducted at an Irish tertiary maternity hospital from January 2018 to December 2020. Cases of pregestational and gestational diabetes were examined for neonatal intensive care admission outcomes. R statistical analysis software was used. There were 3905 live neonates born between 34 and 42 weeks to mothers with diabetes (N = 67 type 1 diabetes, N = 60 type 2 diabetes, N = 3712 gestational diabetes, N = 5 mature onset diabetes, excluded N = 61). There was a statistically significant difference in mean gestational age: 37 + 1 (weeks/days) (95% CI 36 + 6-37 + 4), 38 + 1 (95% CI 37 + 5-38 + 3, p = 0.0019), and 39 (95% CI 38 + 6-39 + 1, p ≤ 0.001) in type 1, type 2, and gestational diabetes cohorts. Admission rate was 13.4% with significant differences between the subgroups: 41.8% [95% CI 2.33-4.58, RR 3.32], 31.1% [95% CI 1.55-3.50, RR 3.89], and 12.5% [95% CI 0.12-0.14, RR 0.133] in type 1, type 2, and gestational diabetes cohorts. A higher percentage of mothers with pregestational diabetes (42.9% and 31.5%) were discharged before their infants, versus 21.2% of gestational diabetes.</p><p><strong>Conclusion: </strong>Neonates of mothers with pregestational diabetes have a significantly higher admission rate. The type 1 diabetes cohort were born earlier and had higher birth weight centiles. Hypoglycaemia remains a significant risk for all subgroups.</p><p><strong>What is known: </strong>• Infants of mothers with T1DM are born earlier and have higher morbidity rates compared to infants of mothers with T2DM or GDM.</p><p><strong>What is new: </strong>• A higher proportion of neonates born to T2DM mothers were admitted due to severe/refractory hypoglycemia, however hypoglycemia was detected after admission in many neonates transferred to NICU for other reasons. It remains a significant risk and requires vigilance of all neonates born to mothers with pregestational or gestational diabetes. • Mothers with pre-gestational diabetes were more likely to be discharged home while their infant remains in NICU.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"354"},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12098415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a predictive model for the progression of Kawasaki disease: a retrospective analysis of clinical and echocardiographic data.","authors":"Hongqiang Yin, Ruijuan Su, Dongmei Liu, Yawen Deng, Ning Ma","doi":"10.1007/s00431-025-06181-x","DOIUrl":"https://doi.org/10.1007/s00431-025-06181-x","url":null,"abstract":"<p><p>This study aimed to identify risk factors for the progression of coronary artery lesions (CALs) in children with Kawasaki disease (KD) and to establish a nomogram for predicting this risk. We retrospectively analyzed clinical and echocardiographic data from KD patients diagnosed at Beijing Children's Hospital from 1 January 2021 to 30 December 2023.The patients were categorized into the progression and non-progression groups on the basis of coronary artery Z-scores and diameters at the 1-month follow-up compared with baseline. Univariate logistic regression identified significant indicators, supplemented by factors from the literature. We used full permutation to examine potential combinations, followed by multivariate logistic regression to calculate the Akaike information criterion (AIC) and area under the curve (AUC) for each model. We selected the best values for establishing a prediction score and nomogram. Model performance was assessed using the AUC, calibration curves, and tenfold cross-validation. Among 1249 patients, 183 (14.7%) experienced progression of CALs, while 1066 (85.3%) showed improvement or stability. Eight independent factors were identified: the baseline maximum Z-score, age, percentage of neutrophils, hemoglobin concentrations, erythrocyte sedimentation rate, albumin, fibrinogen, and intravenous immunoglobulin resistance. The nomogram model showed an AUC of 0.788, with a mean AUC of 0.775 and an accuracy of 85.6% after tenfold cross-validation.</p><p><strong>Conclusion: </strong>The baseline maximum Z-score, age, percentage of neutrophils, hemoglobin concentrations, erythrocyte sedimentation rate, albumin, fibrinogen, and intravenous immunoglobulin resistance are predictive factors for CALs progression in KD. The established nomogram shows high accuracy and reliability, aiding clinicians in decision-making.</p><p><strong>What is known: </strong>• Since the introduction of IVIG therapy, most children with KD show CALs regression, yet a subset experience progressive CALs despite treatment. • CALs progression is associated with increased adverse cardiovascular events, yet predictors of this progression remain poorly characterized.</p><p><strong>What is new: </strong>• The eight-factor predictive model developed in this study effectively identifies progression risks in CALs following treatment, providing a basis for personalized clinical management. • Echocardiography, the primary modality for assessing coronary arteries in children, demonstrates that early baseline Z-score evaluation serves as the strongest predictor for CALs progression, while non-coronary cardiac abnormalities show no significant association.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"355"},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Serum ferritin levels in newborns at 3 months of life after intact umbilical cord milking versus delayed cord clamping\"-a randomized controlled trial.","authors":"Bhavana Koppad, Charkala Rajkumar, Anita Nyamagoudar, Manjunath Hukkeri, Kanchibhotla Meghana, Mrutyunjaya B Bellad","doi":"10.1007/s00431-025-06166-w","DOIUrl":"https://doi.org/10.1007/s00431-025-06166-w","url":null,"abstract":"<p><p>The objective of the study was to compare the serum ferritin levels (by chemiluminescence immunoassay) among two groups of newborns with intact umbilical cord milking (UCM) versus delayed cord clamping (DCC) at the 3rd month of life. Randomized controlled trial, unblinded, parallel group was conducted at tertiary care referral unit in South India after obtaining informed consent from eligible mothers in late preterm gestation and beyond, and the newborn babies were randomized into two groups by computer-generated sequence (SNOSE method) with two modes of umbilical cord management UCM and DCC. A total of 190 mothers were enrolled, and they were randomized into two arms: DCC group (n = 95) and UCM group (n = 95). Of these 190 mothers who were enrolled, the intervention was done for 180 babies, i.e., DCC (n = 92) and UCM (n = 88). Follow-up with serum ferritin was done for 108 babies. DCC-63 and UCM-45. Ferritin levels measured at 3 months of life showed comparable results, i.e., mean ferritin levels in the DCC group was 258.07 ng/ml and in the UCM group was 248.44 ng/ml, with a mean difference of - 9.63 (p 0.72).</p><p><strong>Conclusion: </strong> Both UCM and DCC resulted in comparable levels of serum ferritin at 3 months of life, implying that a similar amount of placental transfusion occurs in both the groups. UCM is a feasible alternative to prevent anemia during infancy as compared to DCC when the latter cannot be done due to undue limitation.</p><p><strong>Trial registration: </strong>CTRI registration number: CTRI/2021/05/033448. (07/05/2021).</p><p><strong>What is known: </strong>• DCC is the standard of care for stable term and preterm babies at birth. However, UCM is a reasonable alternative for cord management at birth.</p><p><strong>What is new: </strong>• UCM prevents anemia as effectively as DCC, as evidenced by comparable serum ferritin levels at 3 months of age, further adding to the hypothesis that UCM is a feasible alternative when DCC is not practical.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"353"},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence to \"Efficacy of oral folinic acid supplementation in children with autism spectrum disorder: a randomized double-blind, placebo-controlled trial\".","authors":"Kamila Castro, Josemar Marchezan","doi":"10.1007/s00431-025-06195-5","DOIUrl":"https://doi.org/10.1007/s00431-025-06195-5","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 6","pages":"352"},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}